Torn arm tendons-- ADVICE

Hi guys, I have 4mm tears in both my arm tendons .. Have already had cortisol injections, followed directions from the Doc to not do any pulling exercises ( he said pushing exercises were ok )... It's been 2 months and the pain has returned to a chronic state since I started dead lifting and bent over rows and bicep curls again... Did none of these while trying to heal, but still went fairly heavy on the pushing exercises.

How long does it take to heal a torn tendon if not doing any weights?

I really do not want to shrink as I have put in so much work to grow! Do any you guys know how long before I start loosing size from not being able to lift.. Im asking how long is the period of muscle retention when not training hard and heavy.
Got to take serious steps here or else I won't be lifting weights again ever... Need to heal. I will be visiting a doc and physio, just want some input from those who might have experienced a similar injury.

It really depends on what grade tear it is, I dunno what they'd class 4mm ?

Also depends WHAT tendon ?

Are you not getting any physio/massage on it ?

Well I could write out the doctors report which he assessed from an ultra sound on each arm.. But, no one here would understand it unless they were a certified practitioner ... Are you a doctor? If not , it would just be a couple of paragraphs of words you would'nt understand.

Looking for insight from people who might of had a severe case of tendinitis.

You have some very bright people on this forums, some who are physical therapists and others who are exercise physiologists. Why don't you lay it on us, as I am curious what tendon it is, whether it is proximal or distal, and the degree of tear as well. Unless of course you want some brotelligence advice like "Dude, I had the same sh**, you just gotta push through"

There's a difference between tendonitis and a tendon tear. The cortisol shot would have reduced inflammation to decrease pain, but would not do anything to promote the healing of the tendon - in fact, in many cases, it would slow the repair. Regeneration of connective tissue is a very slow process, and a full recovery from a tear is not going to occur in 2 months.

Next, taking two months off from all pulling work and then going straight into heavy lifting was a horribly stupid idea. After complete rest you should have started very light, rehab based movements. E-stim of the muscles in the arm that are inactivated are a good way to maintain muscle activity while minimizing tendon shear.

You have some very bright people on this forums, some who are physical therapists and others who are exercise physiologists. Why don't you lay it on us, as I am curious what tendon it is, whether it is proximal or distal, and the degree of tear as well. Unless of course you want some brotelligence advice like "Dude, I had the same sh**, you just gotta push through"

There's a difference between tendonitis and a tendon tear. The cortisol shot would have reduced inflammation to decrease pain, but would not do anything to promote the healing of the tendon - in fact, in many cases, it would slow the repair. Regeneration of connective tissue is a very slow process, and a full recovery from a tear is not going to occur in 2 months.

Next, taking two months off from all pulling work and then going straight into heavy lifting was a horribly stupid idea. After complete rest you should have started very light, rehab based movements. E-stim of the muscles in the arm that are inactivated are a good way to maintain muscle activity while minimizing tendon shear.

Br

Thanks for the solid response. When I return home from work today I will post up the analysis of my report on the injury for you. With regards to the degree of tear, I think it is a partial tear (if that is relevant to what a degree of tear means).
Could you give me an idea of how long a recovery of a tear would take.
I didn't give the injury complete rest, only rest from certain exercises.... This time I will, and wont jump back into heavy lifting.... It's gonna be hard and a little disheartening but injuries happen. I have other type of training to focus on ( hopefully I can still punch with this injury), so will just have to re-focus some goals.

RIGHT ELBOW -- Calcification noted at the common extensor origin. The common extensor tendon is thickened and hypoechoic. Small partial thickness tear of the deep portion of the tendon measuring 4mm in maximal dimentions. The tendon is of slightly increased vascularity on Doppler examination. CONCLUSION: Ultrasound appearances compatible with lateral epicondylitis/common extensor tendinopathy with calcification and partial tear.

LEFT ELBOW -- Focus of calcification at the common extensor tendon origin. The tendon is of diffusely heterogeneous low echogenicity. Focal area of very low echogenicity deep within the tendon consistant with a partial thickness tear. CONCLUSION: Ultrasound appearances entirely compatible with common extensor tendinopathy with calcification. There is also a partial tear through the deep margin of the tendon.

Thanks for taking the time to read or analyse this. Hope it is can help to answer some of my original questions.

I see. Thank you for clarifying, at first thought I was thinking the biceps tendon - not the extensors tendon.

"Calcification noted at the common extensors origin." This would suggest that an overuse/avulsion fracture occurred (in essence, the tendon started to pull away from the bone) and the area is starting to heal. A good round of ice, head, ice - in that order - will help with the process.

The common extensor tendon is thickened and hypoechoic. This means that while the tendon has thickened, it has lost density, or weakened, probably due to inflammation.

"tendon is of diffusely heterogeneous low echogenicity" In simple terms, the amount of inflammation through the tendon is not uniform, and again, the tendon has lost density, or weakened.

My advice:
1. Go see a doc, as you may have re injured it.
2. In the meantime, rest and rotating between heat and ice, or the use of NSAID cream on the outer elbow will help to reduce inflammation and pain. Once the symptoms go away you can start with manual massage and light exercises to strengthen the forearm/hand muscles. Opening and closing your hand in a bag of rice is a good start.
.........And I hate to be the bearer of bad news, but usually injuries like this take > 4-6 months to fully heal. Talk to your doc, surgery may be an option if you want to get back to lifting upper body sooner:

Surgical management is indicated in the 5% to 10% of
cases in which nonoperative treatment fails to provide
lasting relief in a reasonable length of time. Assessment
of the individual patient’s functional requirements provides
the critical factor in timing. Some may be willing
and able to endure a year or more of pain and disability,
whereas others, particularly professional athletes and
manual workers, are given the option of earlier surgical
repair to shorten the period of disability.
There is no merit in a prolonged delay in offering
surgical treatment in the face of persisting symptoms.
This author’s own experience is similar to that of Newey
and Patterson, who found that pain relief was significantly
better in those patients with the shorter duration of
preoperative symptoms.29

(Can send you full paper if you would like...good info about surgery options for lateral epicondyle injuries)

4 to 6 MONTHS.. Ahhh Crap! That is terrible news. Thanks for the informative response.
I know I'm reaching here, but is there a way to continue some upper body work that won't hinder recovery.
I'm thinking of this... Say 10kg dumbbell shoulder presses @ high volume reps.. ie sets of 50/60 reps . It doesn't feel as though it puts strain on the injured tendon, and PUSHUPS as well to stay in shape. I also have adjustable hand grip squeezers... I can set them on easiest tension ( which Is 10kg), and use those to maintain forearm strength.
I'm going to run this past the doc and physio... Curious to see if you think these exercises will be possible to do and heal at the same time.
Well, at least legs are going to cope a hiding.

Well I could write out the doctors report which he assessed from an ultra sound on each arm.. But, no one here would understand it unless they were a certified practitioner ... Are you a doctor? If not , it would just be a couple of paragraphs of words you would'nt understand.

Looking for insight from people who might of had a severe case of tendinitis.

I stated I will be seeking the advice of a physio already.

Do you have any actual experience on this??

WOW, good way of shooting somebody down while they're trying to help.

I am currently working part-time through an MSc in Sport and Exercise Psychology so although I am not a Doctor, I believe I could have gave SOME sound advice or even spoke to others more qualified than myself about this, but not to worry you now have your advice.

4 to 6 MONTHS.. Ahhh Crap! That is terrible news. Thanks for the informative response.
I know I'm reaching here, but is there a way to continue some upper body work that won't hinder recovery.
I'm thinking of this... Say 10kg dumbbell shoulder presses @ high volume reps.. ie sets of 50/60 reps . It doesn't feel as though it puts strain on the injured tendon, and PUSHUPS as well to stay in shape. I also have adjustable hand grip squeezers... I can set them on easiest tension ( which Is 10kg), and use those to maintain forearm strength.
I'm going to run this past the doc and physio... Curious to see if you think these exercises will be possible to do and heal at the same time.
Well, at least legs are going to cope a hiding.

From personal, stubborn hard headed experience, I've found that trying to work through injuries is a bad idea that always results in prolonging or never fully recovering. Look into arm sleeves that allow you to do pull ups or rows on cables without actually gripping the bar. I'm sure you could figure out a way to use them on pushing movements as well.
Talk to your doc, see what they say about it.

I am currently working part-time through an MSc in Sport and Exercise Psychology so although I am not a Doctor, I believe I could have gave SOME sound advice or even spoke to others more qualified than myself about this, but not to worry you now have your advice.

Sorry mate, I must of misinterpreted the tone of your post at the time.
I'm interested in any input you may have with the additional information I've provided about the injury.
I understand if you can't be bothered to now tho. I'm off the doc today about it actually.

Doctors diagnosis -- absolutely no treatment available other than ice and NSAID medication to relieve inflammation , advised against Any more cortisone as it will just delay recovery ... The only option is time off to rest and heal... The worst part is its going to take 9 to 12 months ..
Was really looking forward to achieving some weight lifting goals in 2012. DAMN INJURIES!! it's my own fault tho.. Pushed too hard.

I'm surprised he didn't mention surgical options. I'm not an ortho, but I have seen some surgeons suggest that with that type of injury, surgical options will result in a quicker return to movement, especially in athletes. PM me your email and I'll send you the paper to run it by him/her.

Be careful using NSAID's if you're going to carry on training (even just very lightly) as mentioned on your previous post, there is a lot of evidence in endurance althetes that it actually done more harm that good, so although not 100% accurate for you, it's worth taking note.

Well I could write out the doctors report which he assessed from an ultra sound on each arm.. But, no one here would understand it unless they were a certified practitioner ... Are you a doctor? If not , it would just be a couple of paragraphs of words you would'nt understand.

Looking for insight from people who might of had a severe case of tendinitis.

I stated I will be seeking the advice of a physio already.

Do you have any actual experience on this??

Get Testosterone Cream and apply it ED for about 3-4 weeks straight. Do very mild band-stretching movements to help regain strength AFTER taking the cream for a week. Go to an orthopedic doctor/surgeon and ask for a limited supply of test cream for this purpose only. Rub the cream on your elbow and I assure you it will heal the tendon rather quickly. I have a local doctor that prescribes this often for tendonitis and has had overwhelmingly positive results from patients using it. I also have a friend who also tried this and it worked well for them, too. It took 14 days for his elbow to heal properly to get him back in the gym.

I'm not kidding it works. This is common prodecure for pro bb'ers with joint pains too. You can also get some joint support as well as getting some GHRP to inject @ 100mcg's twice daily to also help with joint support/pain.

Otherwise you'll need to stay away from any heavy free-weight presses, curls, fly movements and pull movements like DB and BB rows for a good 3-4 months to allow proper healing.

Get Testosterone Cream and apply it ED for about 3-4 weeks straight. Do very mild band-stretching movements to help regain strength AFTER taking the cream for a week. Go to an orthopedic doctor/surgeon and ask for a limited supply of test cream for this purpose only. Rub the cream on your elbow and I assure you it will heal the tendon rather quickly. I have a local doctor that prescribes this often for tendonitis and has had overwhelmingly positive results from patients using it. I also have a friend who also tried this and it worked well for them, too. It took 14 days for his elbow to heal properly to get him back in the gym.

I'm not kidding it works. This is common prodecure for pro bb'ers with joint pains too. You can also get some joint support as well as getting some GHRP to inject @ 100mcg's twice daily to also help with joint support/pain.

Otherwise you'll need to stay away from any heavy free-weight presses, curls, fly movements and pull movements like DB and BB rows for a good 3-4 months to allow proper healing.

WOW.. This gave me a huge glimmer of hope... I really appreciate this post.
I have taken your advice and today I went to the doc and he prescribed me TESTOGEL testosterone 50mg satchels. I have a months worth. Is this what I need? Should I apply the whole satchel to the elbows or put some on my stomach or upper arms as well.
The doctor said he never heard of this treatment, but I told him that training is my primary source of recreation and enjoyment so would live to give it a try... Doc also arranged some subsidised physio treatment.
This was a different doctor I went to yesterday !!
Thanks again Fuelpassion for this info, I hope it works... If not I'm gonna have elevated test levels anyway, which will be great... Kinda like a mini cycle! Although I can't train .

That's ok that you cannot train. However, I do recommend that you apply some resistance movements to your tendons ED, such as using the stretch bands that are common for use in physical therapy. I would apply half of the gel to the arm and the other half to the abs.

I believe the action behind the testosterone is that it contributes to regeneration of damaged tissue. Anti-inflammatories, while they reduce pain in the joints, are counter-productive in rebuilding tissue whether it's muscle or tendons. You should avoid using them often.

And like any other muscle or joint in the body, I believe every week you should apply gradual increases in resistance to the tendon to strengthen it alongside any therapy you might be getting. Good luck and keep me posted thru PM's.

Oh and you should take advantage of the gel and have some killer leg routines thrown in there to at least make progress on your lower body (which is more important than upper body anyways).